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Author
Topic: HIV Diet / Wasting. (Read 5283 times)

I am a Cardio freak. I surf, I skateboard, I ride my bicycle a lot, I walk, I run, I hike, I practice Bikram Yoga and very carefully watch what I eat. I do not drink alcohol.

I have recently gone 100% Vegan just based on the way it made me feel and the energy I got from the lifestyle. Since my last set of test results (4 months) I lost 12 pounds. I have had a few people come up to those close to me and asking them if I was Ok. I feel great and not sure if it wasting or just my new diet plus the vass amounts of cardio I do 5-6 days a week.

The short answer is "YES". Vegans frequently do not get an adequate amount of protein and other nutrients.

^^this.

Our dear departed Moffie used to stress that people living with hiv need plenty of protein in their diet. If we're not getting enough protein, our bodies start to scavenge protein out of our own muscles.

If you haven't already, you may want to read through this site's Nutrition Lesson. It's basic, but will give you a start.

In my own experience, I was a lacto-vegetarian for the first ten years or so of my infection. I started craving chicken and when I finally started giving in and eating small amounts of animal protein each week, I began to have more energy. I have to admit that I wasn't as careful about my vegetarian diet as I should have been.

You may want to consult with a dietician who has experience in advising hiv positive people and who is also familiar with a vegan diet. You may be able to continue with being vegan, but you'll have to be vigilant about sourcing your proteins and making sure you're getting all the amino acids that you need. Some of the amino acids we need simply aren't available from plant-based proteins.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Edited to add; If God hadn't intended us to eat natures creatures he wouldn't have made them so delicious.

I eat a moderate amount of lean chicken and fish because it is a simple and easy way to get protein. Very very little red meat for me. But there are more than enough ways for a vegan to get plenty of protein.

« Last Edit: July 28, 2013, 03:15:41 PM by bmancanfly »

Logged

"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

You mention that you are very active, are you eating enough calories to maintain that level of activities? When switching from animal based to vegetarian based diet you need to account that an ounce of meat has a very high amount of calories compared to a similar ounce of plant based food.

Americans are obsessed with protein. A well balanced diet be it standard or vegetarian/vegan should provide plenty of protein.

What has been said is that a vegan or vegetarian has to be vigilant about their diet and - quite often - rather creative about ensuring they're getting enough protein.

Some essential amino acids (the building blocks of protein) are difficult to source in a vegetarian diet and very difficult to source in a vegan diet. I know because I've been there, done that, and failed miserably.

(As an aside, part of the reason I failed was because I was following a lacto-vegetarian diet, which means diary is ok, but eggs are verboten. Many vegetarians rely on eggs for those essential amino acids I keep banging on about.)

Being a healthy vegan or vegetarian requires dedication and a good knowledge of dietary requirements and how to source essential amino acids. It's not a diet you can get lazy on (like I did) and try to subsist on vegetarian fast-foods or ready-meals.

You need to like to cook, or at least like to source and prepare fresh foods. Relying on supplements in the form of pills or powders to make up the short-fall doesn't really cut it. The bulk of your nutrients needs to come from actual food, the less processed, the better.

Ironically, eating a strict, healthy, vegetarian or vegan diet can be expensive and time-consuming.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Anybody who has ever been on a vegetarian diet knows that the first question that everyone ever asks you about it is "how do you get enough protein". And they often say it with such grave concern for your well being. That fact is, with minimal effort, vegans can get all the protein they need - for vegetarians it's even easier. Most people eat way more protein than necessary anyway.

The OP asked;"Should I be eating more meats in my diet?"

and the answer he got was

"The short answer is "YES". Vegans frequently do not get an adequate amount of protein and other nutrients."

When actually the short answer is "not necessarily". While some vegans, doing the diet improperly don't get enough protein, it is entirely possible, with a minimum of effort, to get adequate protein in a vegan diet. If you feel better on a vegan diet, and enjoy it (??), than continue doing it, but as the others here have clearly stated you have to make more of an effort to get adequate protein. However, it's not nearly as difficult as the general public believes. And "no" eating animal protein is not necessary.

It seems more likely that the OP has a calorie deficit problem than a protein problem. All that cardio is burning a lot of calories.

My only question is, why would you want to be a vegan? Animals are yummy.

Logged

"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

First, wasting syndrome caused by HIV involves involuntary weight loss of more than 10% of baseline body weight that is associated with either chronic diarrhea or chronic weakness and documented fever for more than 1 month, so take heart that you're probably not wasting. I didn't do the math.

If you're interested in nutritional changes brought on by HIV infection, I refer you to this WHO report which discusses the increase in our resting energy expenditure required just to fight the virus and says, for example:

"Energy requirements are likely to increase by 10% to maintain body weight and physical activity in asymptomatic HIV-infected adults, and growth in asymptomatic children. During symptomatic HIV, and subsequently during AIDS, energy requirements increase by approximately 20% to 30% to maintain adult body weight."

There's a lot more information there. It's out-of date (2003), but a good read.

And by the way, "poppycock" to it all. I eat tuna maybe once a week. Everything else that goes in my mouth is pretty much a dried fruit, a nut, coffee with milk (no sugar) or tiramisu - with rare exceptions to this pattern. And still I cannot lose more weight no matter how I try. ("No matter how" excludes exercise beyond NYC walking, lol.)

Nutritionists over-generalize about the actual requirements of the average human body. RDIs are the "intake level of a nutrient that is considered to be sufficient to meet the requirements of 97–98% of healthy individuals in every demographic in the United States". Your mileage will vary, sometimes considerably depending on your ancestry, the sedentary (or not) nature of your life and dozens of other factors that we're only beginning to understand.

I have recently gone 100% Vegan just based on the way it made me feel and the energy I got from the lifestyle.

I'm glad you're feeling great but I'm not a big fan of any extreme diet regime, whether vegan, Atkins, whatever. It's possible to eat a well balance diet and feel great too, without all the effort of these extreme diets.

If you had 4 oz of fish at lunch, and 4 oz of skinless chicken breast (antibiotic and hormone free) at dinner, you would have already exceeded the USDA protein requirement for an adult male. If you look at what a 4 oz piece of chicken or fish looks like (they're tiny) it's hard to imagine how that amount is going to adversely affect your feeling of well being. Plus it's a cheap, easy, condensed source of amino acids.

Since you are so active you might want to get more protein which could easily be gotten with organic egg whites. There is no dietary or health reason to completely abstain from all animal products. It's just a fad, unless you have some sort of moral objection.

Logged

"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

Interesting. I wonder if this still applies in a scenario where the person is on HAART and undetectable?

That's the problem with such an outdated document. It doesn't even contain the word "undetectable". However, in the reference section there is an article called "Prevalence and predictors of HIV-associated weight loss in the era of highly active antiretroviral therapy." It too is out-of-date (pre-Atripla even), but according to the abstract:

"This study was a cross-sectional study of 122 HIV-positive subjects to determine the prevalence and predictors of weight loss in the era of highly active antiretroviral therapy (HAART). Forty per cent reported lipodystrophy, 40% had documented weight loss (mean 6.6 kg). Mean intake 13,400 kJ (118% of estimated requirements calculated using the Harris-Benedict equation). One hundred (82%) were taking antiretroviral therapy. Using forward stepwise logistic regression analysis only viral load (VL) was significantly associated with weight loss when intake, CD4 T-cell count, lipodystrophy, and age were entered into the model with VL (log copies/mL). Every one log increase in HIV VL was associated with an odds of weight loss of 1.58 (P=0.0008).Weight loss is still common in the HAART era. HIV VL was the most significant predictor of weight loss in this sample. Inadequate dietary intake and self-reported lipodystrophy were not related to weight loss in this population."

I should probably seek out more current information, but some of this likely still holds as a general guideline.

I haven't read it yet, but I think it's geared for someone on a non-Western diet. Still, it has facts and pointers related to such topics as:

The effects of nutrition on HIV The three ways in which HIV can affect the nutritional status of a person are by: Reducing food intake; Lowering food absorption; and Increasing energy requirements. [continues with details and pointers on each]

There's an entire section called "Session 7: Nutrition for people on antiretroviral treatment"

It's all a bit elementary in tone, and there's lot of basic filler, but still, you have to start somewhere. I'll give it a read and let you know if I find anything groundbreaking.

I haven't read it yet, but I think it's geared for someone on a non-Western diet. Still, it has facts and pointers related to such topics as:

The effects of nutrition on HIV The three ways in which HIV can affect the nutritional status of a person are by: Reducing food intake; Lowering food absorption; and Increasing energy requirements. [continues with details and pointers on each]

There's an entire section called "Session 7: Nutrition for people on antiretroviral treatment"

It's all a bit elementary in tone, and there's lot of basic filler, but still, you have to start somewhere. I'll give it a read and let you know if I find anything groundbreaking.